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What Is Azithromycin?

Azithromycin is a prescription macrolide antibacterial used for selected mild to moderate infections caused by susceptible bacteria. Adult tablet indications include certain respiratory infections, sinusitis, pneumonia, pharyngitis or tonsillitis, uncomplicated skin infections, urethritis, cervicitis, and genital ulcer disease in men. Pediatric tablet or oral suspension indications include selected ear infections, pneumonia, and pharyngitis or tonsillitis.

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What Is Azithromycin?

Azithromycin is a prescription macrolide antibacterial used for selected mild to moderate infections caused by susceptible bacteria. Adult tablet indications include certain respiratory infections, sinusitis, pneumonia, pharyngitis or tonsillitis, uncomplicated skin infections, urethritis, cervicitis, and genital ulcer disease in men. Pediatric tablet or oral suspension indications include selected ear infections, pneumonia, and pharyngitis or tonsillitis.

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How Does Azithromycin Stop Bacterial Growth?

Azithromycin binds to 23S ribosomal RNA within the bacterial 50S ribosomal subunit. This blocks bacterial protein synthesis and interferes with assembly of the 50S ribosomal subunit. Susceptible bacteria are unable to make proteins needed for growth and replication. Resistance can occur through changes to the ribosomal target and other bacterial mechanisms.

Which Infections Are Treated With Azithromycin?

Adult uses include selected cases of bacterial bronchitis exacerbation, acute bacterial sinusitis, community-acquired pneumonia, pharyngitis or tonsillitis as second-line therapy, uncomplicated skin infections, urethritis, cervicitis, and chancroid in men. Pediatric uses include acute otitis media and pneumonia from age 6 months and pharyngitis or tonsillitis from age 2 years under labeled criteria.

How Are Azithromycin Tablets Dosed?

Dosing depends on the infection and patient age. Common adult regimens use 500 mg on day 1 followed by 250 mg once daily on days 2 through 5. Acute bacterial sinusitis uses 500 mg once daily for three days. Pediatric dosing is weight based. Tablets can be taken with or without food.

What Serious Reactions Are Linked to Azithromycin?

Serious risks include severe allergic reactions, liver injury, QT prolongation, torsades de pointes, cardiovascular death, Clostridioides difficile-associated diarrhea, worsening myasthenia gravis, and infantile hypertrophic pyloric stenosis after neonatal exposure. Diarrhea, nausea, abdominal pain, and vomiting are common adverse reactions. Heart rhythm risk is greater in people with existing QT-related risk factors.

Frequently Asked Questions About Azithromycin

Is azithromycin a macrolide antibiotic?

Yes. Azithromycin is a macrolide antibacterial that blocks bacterial protein synthesis at the 50S ribosomal subunit.

Does azithromycin treat viral infections?

No. Azithromycin treats selected infections caused by susceptible bacteria and does not treat viral illnesses such as colds or influenza.

What is a common five-day azithromycin regimen?

A common adult regimen uses 500 mg on day 1, followed by 250 mg once daily on days 2 through 5.

Can azithromycin affect heart rhythm?

Yes. QT prolongation and torsades de pointes have been reported, with greater concern in people who have existing rhythm risk factors.

References

Azithromycin. MedlinePlus. https://medlineplus.gov/druginfo/meds/a697037.html. Date Accessed September 15, 2026.

DailyMed - AZITHROMYCIN tablet, film coated. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ec619299-e0ef-44dd-acdb-8c53bbfc5b8a. Date Accessed September 15, 2026.

DailyMed - ZITHROMAX (azithromycin dihydrate) tablet, film coated and powder, for suspension. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=db52b91e-79f7-4cc1-9564-f2eee8e31c45. Date Accessed September 15, 2026.

FDA Drug Safety Communication: Azithromycin (Zithromax or Zmax) and the Risk of Potentially Fatal Heart Rhythms. https://www.fda.gov/files/drugs/published/FDA-Drug-Safety-Communication--Azithromycin-%28Zithromax-or-Zmax%29-and-the-risk-of-potentially-fatal-heart-rhythms-%28view-and-print-version%29.pdf. Date Accessed September 15, 2026.

ZITHROMAX (azithromycin) Tablets and Oral Suspension Prescribing Information. https://labeling.pfizer.com/ShowLabeling.aspx?format=PDF&id=511. Date Accessed September 15, 2026.